What symptom might indicate an issue in a patient with breast pain and tenderness localized at the nipple area?

Bloody discharge from the nipple can be a significant indicator of concern in a patient experiencing breast pain and tenderness, particularly when localized to the nipple area. This symptom raises the possibility of underlying pathologies, such as intraductal papilloma or even more serious conditions like breast carcinoma. The presence of blood in the discharge suggests that there may be some type of pathological process occurring in the breast tissue, which warrants further evaluation, including imaging studies and possibly biopsies to ascertain the underlying cause.

In contrast, while fever and worsening shoulder pain may suggest other medical issues, they are not specific to breast concerns. Persistent lumps could also indicate a problem, but when considering the specific symptom of localized tenderness and pain at the nipple, bloody discharge stands out as the most alarming and relevant signal that could indicate a serious issue needing prompt attention.